Michael Kenneth Tax, LPN
NPI #1790244317 in Port Jefferson, New York
Provider Information
- NPI Number
- 1790244317
- Entity Type
- Individual
- Name
- Michael Kenneth Tax, LPN
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Practical Nurse
- Credential
- LPN
- Enumeration Date
- Mar 13, 2019
- Last Updated
- Mar 13, 2019
Practice Location
- Address
- 125 OAKLAND AVE STE 204
- City
- Port Jefferson
- State
- New York
- ZIP Code
- 11777-2130
- Phone
- (631) 686-1414
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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